From now on, most Israel Prisons Service (IPS) inmates who are ill and need hospitalization or treatment in public places will not have to be handcuffed. The change in policy was made after seven years of lobbying by the voluntary organization Physicians for Human Rights-Israel (PHR-Israel). Under the new procedures, the default position has shifted from handcuffed to unrestrained. In cases in which the IPS deems handcuffs essential, prison officials will be asked to present the treatment facility with a form giving the reasons. PHR-Israel said that a major problem with handcuffing prisoners receiving medical treatment is the violation of basic dignity. In the past, many prisoners chose to forgo medical treatment, as they were unwilling to remain in the hospital under such conditions. An example of the state of affairs that existed was illustrated by Muhammad Ashkar, who while hospitalized was chained to his bed while he was unconscious and died a number of hours later while still restrained. His mother, when she reached the hospital, was forced to see him in this state in his final moments, the organization said. After dealing with numerous instances of handcuffing and countless petitions to various hospitals with requests from doctors that patients not be handcuffed, PHR initiated a conversation on the topic in the Justice Ministry. As a result of these conversations, in which other organizations participated, the Prisons Service formulated a new policy on the topic of handcuffing prisoners in public places, including handcuffing in hospitals. Anat Litvin, PHR's director of inmate affairs, welcomed the decision. "It is important to remember that the great majority of Palestinian inmates will remain cuffed, and that many years have passed since the issue was first raised," she said. "It took constant appeals to the Justice Ministry before the desired changes came about. "We regret that the change could not have taken place through direct talks with the Prisons Service. We will continue to monitor and make sure that the new regulations will be implemented."